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COMPLIANCE INFO_2021-2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0537388
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COMPLIANCE INFO_2021-2024
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Entry Properties
Last modified
6/4/2024 2:32:01 PM
Creation date
3/28/2023 2:56:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
FileName_PostFix
2021-2024
RECORD_ID
PR0537388
PE
4121
FACILITY_ID
FA0021491
FACILITY_NAME
EMERALD TATTOO & PIERCING (JOSH HUGHES)
STREET_NUMBER
2525
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
06024007
CURRENT_STATUS
01
SITE_LOCATION
2525 S HUTCHINS ST #8
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Body Art Facility Infection Prevention And Control Plan <br />8. Tattoo machine and Cli Cord: WPM�iJ! /J` J'r�'(�� w`!7N ,M9�r7c!/�� �iJ 9� <br />p �+ lf'r1AY�� AC�9rr✓ AWrJ G✓�✓�c�) <br />gcu�bdre) Zo .i)�Y �[^_ /� .uvx,hwtit riF .�%k ( ,i Ti�,S/ <br />�r�: .gFFc�P�(�T� 1'�2FRC�J" 9� r>l��u r���IP�v Gf/ X11 ����d !'.ea � / r�-fo .�'iq <br />s ���r� r �rfl'a JA.�r� CiaP (�oQi) e6 ►/i -RS' 7k'fT 9�� <br />v,gr��r w9slc <br />9. Reusable instruments, calipers, needle tubes, etc. portable light fixtures or other: � Fr, Jrr f,,yl,� r � <br />�/ E F-�(r�G ,Q'e CEVrd� T✓�'�l 9n��� (`,� L VX�C-� J /,� I/A,�d fCrGu�'�,� (r+74 � Il `�. <br />��,tic,��r� T� C/x-�� iu .f�� �d vtln olr �� V�-y ��d S«�/i-r�e-Dr �' FrJ � 9cccw �-rJ <br />!r AFPCrC�glr , r"r�ryt44Lc- �lC-!(7 TlK7�'�j � .1P�lY�J c✓r Ty Mfiil r} Or <br />/aay r}ar) %T(E� S/'i2-9YErJ %Cr�9/N �N(� C"/�� <br />10. Permanent Cosmetic Machine: �uT /}/'PuC�(!l <br />B. Reusable Instruments or Disposable: Describe the procedures used for decontaminating, <br />sterilizing, packaging and storing of reusable instruments. Include the procedures for labeling of <br />sterilized peel -pack. Indicate whether the body art facility uses all pre -sterilized, single -use and <br />disposable instruments. Describe the record keeping logs and procedure logs maintained on-site <br />when using 100% pre -sterilized, single -use and disposable instruments (California Health and Safety <br />Code 119309 and 119315). <br />1. Needle tubes: /VST �f�fuCq�C� fi'rT<I �.! 'r%QE �/-,�Ea'TGY (/ilNc� /'rJ%�I2 <br />/lf�C4'1,U�7—/�fUT Co/G �. �� %'/�/NG i?��HVI/�-G, fU_/�1 _ff"� �� ii-��'YC <br />q.`c Nf-EOcE/ /f2� �/cnI'9�-Cy �'Gvcr> vlT�r 7Lr� p9o� G�r�z� �''� �'�r�� <br />rrLOC���'u-C 2r (�T C[E$�d M�✓9G['/l.�dlGi) 9�0) 7ktvu .Tt9cCJ� <br />2. Calipers: 2E-U�9g�e %axJ 9 f � !J' <br />(r J�,u��t7/rte vrlc��rN,U- 9w� ��rip��y t�9g��r�., �rc��� �o�h- <br />��,, Ntva�.cY �c�C-c�J �e �JN Gy9� �=�9w�1 tcO 9Fr z G�gr��' ,��ll ��c �;,..i <br />.S7a�!) IN ''CG��^l ,. %OUG %��)< Orz/ .PPEeIFI�d dF�9� 6rz rfNTll. L'Sc, !F �L (e�cC.� <br />[!}Nc/� WILL � ,f CO��) fry W-9TLvz/ /N T,�"r. S`%¢iNtt�f �('T �"r<� <br />C$�'^'� r 5'i' I�+�)r?l£�� CL /N 7it"C CLEAN /1UoM <br />3. Other instruments: ��'r/� <br />AN7 O`Ct-(�/� INf ��'�`�"7r A� Sc�ug.�J Ard Drtr>i/J 01 APr'� rC.f�9c c hrw <br />STe-nlLlZi;A cerEMlr9i��l e� "fcrru�C—er iL(Z A✓7"oC���l�_ �l�re�rr� <br />f�dG�!%V2�1 G�LlNfGJ) fW '"jt/Il I�OC��!"��N ! <br />Page 3 of 11 <br />
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